Hi, I’m Claire Glenton, a professor of evidence-based practice and one of the principle investigators of the mHealth-Innovate project. We’ve been spending the last few years exploring how healthcare workers use their phones informally to plug gaps in the health services. Our research has helped to identify how healthcare workers frequently use their own phones to call patients and colleagues, store and send patient information, and several other day-to-day work tasks.
As we learn more about this type of informal behaviour, our understanding has become a bit more nuanced. For instance, we were (and still are) sympathetic to the challenges that healthcare workers face and understand how these informal approaches help them deliver the tasks expected of them. At the same time, we were concerned about possible problems, including breaches in patient privacy and confidentiality. We are still concerned about these issues, but our research has also led us to acknowledge that this direct contact between patient and healthcare worker via their own phones can help humanise healthcare by offering personalised solutions. Nevertheless, this comes at a cost to the healthcare worker, including phone and airtime costs as well as being constantly “on call”. And while healthcare workers are using their own resources to plug gaps in the formal system, this also weakens the formal system because important information about patients as well as logistical data is sometimes only stored on private phones.
The situation is complex and deserves thoughtful solutions that consider all of these perspectives. We think that some level of regulation is probably necessary, for instance, to protect patient confidentiality. At the same time, we don’t think that regulation alone is the answer and believe that the health system gaps that explain a lot of this behaviour also need to be addressed. Even where these gaps have been addressed, we would argue that healthcare workers need some level of independence and flexibility in order to develop locally relevant solutions, to thrive and feel empowered, and to deliver quality healthcare services.
We look forward to hearing HIFA members’ thoughts about this phenomenon, why it happens and if and how it should be addressed.
HIFA profile: Claire Glenton is professor of evidence-based practice at Western Norway University of Applied Sciences and a researcher at Cochrane Norway. Claire has a particular interest in systematic review methodology, including methods for disseminating the results of systematic reviews and methods for synthesising qualitative research. She regularly serves as technical advisor on World Health Organization guidelines. She also co-coordinates the GRADE-CERQual Project Group. She is one of the principal investigators of the mHealth-Innovate project, looking at informal use of mobile phones by health workers. Claire.Glenton AT hvl.no